术后吻合口扩肛和吻合口护理、吻合口炎的处理
第一节 术后吻合口狭窄的扩肛过程和便秘及吻合口炎的关系
不管是低位直肠癌或者是中高位直肠癌,患者的吻合口一般手术医生都是吻合在肛门以上4-6公分处,患者自己或者手术医生复查指检时都可以摸到;而吻合口直径一般比原来的肠腔小,所以术后患者的吻合口就比原来的肠腔狭窄,在肠道里出现了一个“关口”,有经验负责任的手术医生术后复查时都会通过指检,医生的手指指检时用力按压吻合口转一圈,使吻合口的术后粘连分开,使吻合口不要因为新长的吻合口组织粘连导致吻合口太狭窄,大便通过困难;往往医生指检之后手套会带血,这是术后必要的一个扩肛过程,有些医生医嘱患者自己回家自己扩肛,我觉得是不负责任的做法,患者不带手套指甲划伤吻合口或直肠怎么办?患者或家属用力过大造成吻合口漏怎么办?
群里有一个超低位保肛的患者术后怕梗阻而几个月都吃流质食物,导致大便稀溏不成形,患者的吻合口术后几个月都没有硬点的大便通过吻合口,导致吻合口狭窄,三个月回医院复查时,医生知道她不敢正常吃东西导致大便长期稀溏,医嘱要正常吃饭,要多吃有大便的食物让成型的大便、乃至硬便给吻合口扩肛,术后吻合口才不会狭窄,而有些医生会让患者自己买扩肛的器械自己扩肛,但是,我的手术医生告诉我,那些器械的型号都偏小,说他做的吻合口最大的型号都可以通过,可见术后叫患者自己扩肛的做法,还不如教会患者正常吃饭。
第二节 术后不懂护理、调理吻合口炎的患者进入恶性循环之后苦不堪言,护理、调理得当很快就能够解决问题。
患者术后普遍都会因为术后大肠功能受损,术后4-5年才能够完全恢复大便正常,年轻人恢复得快在第一二年都会因肠功能失调,大便经常性的反复于便秘、湿热、拉稀之间,大便循环到便秘时候的第一天,其实就是一个很好的扩肛过程,患者大便时还可以用腹压控制硬便或干燥的大便通过吻合口的温柔程度;不过,既然达到扩大吻合口的作用了,就必然会挤伤吻合口的粘连或者新长的肉芽而出血,这时便秘的第一天,最慢是第二天就要服用清热解毒的非处方中成药,或者服用凉血凉肠的中草药水,让被大便挤伤出血达到扩肛效果之后的吻合口不容易发炎,要塞中成药消炎栓剂或消炎药膏进肛门,帮助吻合口消炎,才不会导致吻合口出血之后发炎,多次出血发炎之后、糜烂,形成吻合口炎,吻合口炎又导致疼痛性大便紊乱,大便紊乱又加剧吻合口炎的恶性循环,最终严重到吻合口附近肠粘膜糜烂脱落随大便拉出来透明的物质,受到惊吓之后才重视起来就比较难于调理和护理了。
肠癌群里经常有不认真或不懂按照上述方法护理、调理吻合口的患者,直到大便拉出来透明的物质时,惊慌来群里说的时候,才知道已经形成了很严重的吻合口炎了,我指导她们调理起来就更加困难很多,调理期间既要实时的调理患者不要便秘,还要调理不要湿热,还得给吻合口消炎,还得口服凉肠的中草药水给肠子消炎,白天大便多时,每次大便之后塞消炎膏,晚上没有大便时塞药量比较大的消炎栓剂进肛门,整套正确护理、调理的方法做得很到位一段时间,才能够把严重的吻合口炎调理好,而就是炎症完全消失之后,粘膜层长回去都要数月的时间,期间反复会出现便秘的硬便还会脹伤吻合口,而湿热的大便还会刺激没有粘膜层保护的吻合口肠壁,导致护理和调理起来非常困难,极大的破坏和弱化直肠和肛门的正常功能;没有人指导的患者更加在这种反复出现的炎症疼痛的过程中苦不堪言,疼痛性大便紊乱更加说拉就拉,根本就控制不住,导致很多患者术后几年都还不敢出远门。
第三节 自己亲身经历加上几十年护理痔疮、看大便形状调理肠胃的经验,独创术后护理、调理吻合口炎、肛门炎症的系列方法行之有效,推广后被肠癌群数千患者效仿,效果极佳,得到肠癌群友数不清的赞誉。
而我术后自己懂得调理,吻合口基本在回纳之后没有像样的发炎时间,一周之后就基本在家能够控制便意时走到厕所,两周可以顺着有厕所的路线出门遛弯,三周可以有便意时憋10分钟找厕所上,四周可以出远门,两个月后就可以坐高铁,坐飞机跨省出差或旅游了!
我术后参加了化疗前化疗护理培训班的培训,阅读了化疗医院阅读室几乎所有有关化疗期的护理书籍,加上自己以前经常使用中成药口服液调理肠胃性感冒和大便湿热;用清热解毒中成(草)药调理便秘驾轻就熟,几种调理大便紊乱的方法,三种调理好的时间大概准确到12-36小时;而我有痔疮护理经验还做过痔疮手术,经常使用凉血解毒的中成药片调理痔疮炎症,以前治疗调理痔疮的消炎药膏和消炎药栓就成为我回纳后肛门疼痛型大便紊乱的内服外敷的宝贵药物。
这几个我特别了解的中成(草)药药物,顺理成章的就成为我化疗期间2-3种大便紊乱的调理药物,而回纳后吻合口的调理药物,加上医院化疗后配有遏制胃平滑肌蠕动的止吐药和遏制肠道平滑肌蠕动的止泻药,我在术后止呕止泻方面做得非常好,除了第一次因为早上吃完饭才记得吃止呕药,吐了1次,第二次开始就基本没有吐过,造口袋发响我就知道腹泻了,就吃止泻药,肛门疼痛和吻合口炎症方面,我使用消炎药膏和消炎栓剂,也很快就恢复正常了,化疗期间坚持每天晚上饭后出去遛弯2个小时,帮助消化吸收,所以化疗期间不瘦,还胖了难得的2公斤!后来建群至群友2000人爆群不断比较之后才发现,我在治疗肠癌选择专家医生给我做的手术近乎完美,有些记录至今没有近似的完美手术病例可以媲美;特别我自创独具一格的术后、化疗期、康复期的护理、调理方法,创造了很多很多的第一和唯一,跟几千个群友比较之后我才知道,我治疗过程中的护理、调理、康复过程都堪称完美两字。
第四节 五种大便紊乱的护理、调理网站电子书里都有行之有效的方法
而疼痛性的大便紊乱只是我总结出来的肠癌患者整个治疗过程、和康复过程中的一个大便紊乱的原因和调理方法而已,而我最后总结出来的大便紊乱总共有五种之多,计有:一、放射性大便紊乱;二、疼痛性大便紊乱、三、便秘型大便紊乱,四、湿热型大便紊乱、五、药物刺激型大便紊乱、而每种大便紊乱的护理和调理方法都不一样,而这五种大便紊乱都可以通过正确的护理和调理方法,在一定的时间内调理好。
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